Focusing on the Good: Creating a Healthy Work Environment Through Meaningful Recognition

Knowing that a Healthy Work Environment (HWE) is important to patient care and overall quality of care, the American Association of Critical Care Nurses (AACN) developed specific standards for creating a HWE. It is the research conclusion of the AACN that the HWE exists because of the nurses’ effort to create and maintain the HWE. According to the AACN (2005), the AACN Standards for Establishing and Sustaining Healthy Work Environments include: Skilled Communication, true collaboration, effective decision-making, appropriate staffing, meaningful recognition, and authentic leadership. While a HWE is both fundamental and necessary for nurses and healthcare, a HWE also contributes to increased nursing satisfaction. When a HWE is created, the healthcare team works together to deliver quality patient care and to create an atmosphere conducive to healing for patients and increased well-being for nurses (Miracle, 2008). According to Miracle (2008), a HWE fosters leadership growth in its staff and recognizes the importance and expertise of the nursing staff. The entire healthcare team must work together to foster good communication skills where nurses are a valued resource. The conclusion we can gain from this insight is effective communication, meaningful recognition and authentic leadership breeds a HWE. “The absence of appreciation by the hospital or by the team can result in negative feelings about duties and lack of motivation to be high achievers. Consequently, nurses eventually feel exhausted, decreasing work quality. Therefore, a reward system should be introduced to increase employee motivation and loyalty towards their jobs and the hospital and improve their work quality” (Nursalam, N., Fibriansari, R. D., Yuwono, S. R., Hadi, M., Efendi, F., & Bushy, A. (2018).

According to the AACN (2012), a HWE requires skilled communication. According to Cetin et al., (2012) “communication competency within this context serves as one of the main pillars that leads the leaders potential to leave a positive influence on the employees. In this respect, leadership style and communication competency could be seen as the fundamental dynamics affecting the job satisfaction of employees” (p 228). Scholarship on communication demonstrates communication competency of the manager has a significant role on the satisfaction of the employees. Flauto (1999) studied on a typology or taxonomy of communication competence, in which he noted that leadership is a social process involving a relationship between individuals (Çetin, Karabay, & Efe, 2012, p 228). Cushman and Craig (1976) suggested that listening and negotiating skills of the managers are the determining factors in communication competency. “Pavitt (1999) noted that managers need to be collaborative in their ways of communication in a way to create a two-way channel so that employees can internalize the vision created as a team” (Çetin, Karabay, & Efe, 2012, p 228) and work effectively to create a healthy work environment.

Another element of the AACN Healthy Work Initiatives (2012), is meaningful recognition where staff and management alike are recognized for the value they bring to the organization. Staff need to feel satisfaction in the work they are performing and appreciated for the work that they do. Nurse leaders need to recognize staff in a positive way regularly when working toward a HWE. Likewise, staff need to be empowered to recognize others in the workplace for the contributions that they make to the HWE.

A third tenet of the AACN HWE (2012) initiative is authentic leadership where the leaders are responsible to embrace a HWE and to engage others in the creation and sustaining of the HWE. Nurse leaders are responsible to model both skilled communication and meaningful recognition as they lead staff in creating a HWE. Leadership that is focused on the HWE yields many benefits for the staff and healthcare environment including qualified communication, genuine cooperation, effective decision- making, proper staffing, meaningful recognition and genuine leadership. What is astounding, it will not only alter the process of work but will also create a HWE that is productive.

Purpose

The purpose of this project was to identify the drivers of nurse engagement on a cardiac unit at a large tertiary hospital in Buffalo, NY. The end goal was to identify what would help nurses enjoy coming to work and want to take more initiative; and improve communication between management and staff. Given the literature, it is believed that supporting a HWE will result in improved job satisfaction, improved patient care, and nurse driven initiatives.

Methods

This project included a survey of the floor nurses to identify aspects of communication and job satisfaction that were important to the staff. Baseline data on current communication between staff and management were obtained. A group of staff was convened by the project manager to discuss methods of improving the communication on the unit as well as methods to promote a HWE.

Implementation

A communication board was implemented for the purpose of promoting skilled communication, meaningful recognition and authentic leadership. The project had the end goal of breeding positivity between management and staff and employee retention through the support of a HWE. The communication board was located in an easily accessible, common area and displayed for a three-month trial period. Use by all staff members as well as the leadership team was encouraged. Staff and leaders were encouraged by the project leader to post positive communication and complements as well as positive events that occurred.

Results

After three months of the communication board implementation a follow up survey was performed, the same questions on communications between management and staff were asked. 23 nurses responded to the survey, 78% of those that responded said communication between staff and management was good, while only 22% responded average communication. The surveys showed a 26% increase in communication, in the three months that the board was implemented.

Feedback from staff and management was enthusiastic and supportive, staff felt appreciated and management felt involved. The communication board because a place not only to put professional notes, but personal notes as well. When a nurse had a baby, it was announced on the board, if another nurse was leaving, a message was placed about how much they would be missed. The communication board helped make announcements such as employee of the year, and other times just a thank you was written.

The nursing supervisor had a meeting with managers from different floors and they stated that they had heard about the communication board. They had positive feedback about the board and were interested in introducing a communication board on other floors, to encourage feedback between staff and management.

Conclusion

In conclusion, this project was successful. Staff would be able to come in each day and have a visual reminder of a positive action that was done the night before or week before. Management has decided to keep the communication board indefinitely and another survey will be done in the future to see if progress is continually being made.

Introducing a communication board is important to ensure a program that would foster positive and open communication between management and employees leading to a healthy work environment. Healthcare continues to grow and change daily, because of this, managers need to help to facilitate this profession effectively at all times by implementing open communication with positive feedback. Promoting a HWE through positive communication, meaningful recognition and authentic leadership is projected to improve patient outcomes and foster job satisfaction.